非血运重建的冠状动脉多支病变患者优化治疗方案中曲美他嗪的作用  

Effects of trimetazidine on optimized conventional standard treatment of patients with multivessel coronary disease without revascularization

作　　者：申文祥[1] 党瑜华[2] 李琚平[1] 牛锁成 

机构地区：[1]河南省濮阳市人民医院心内二科,457000 [2]郑州大学第一附属医院心内科

出　　处：《临床医学》2017年第2期4-5,共2页Clinical Medicine

摘　　要：目的评价曲美他嗪在非血运重建的冠状动脉多支病变患者优化治疗方案中的作用。方法选择冠状动脉多支病变但未行血运重建的患者115例,随机分为曲美他嗪治疗组和对照组,两组均按急性冠状动脉综合征给予规范治疗,曲美他嗪治疗组加服曲美他嗪。检查两组患者入选时及治疗后6个月的24 h动态心电图心肌缺血总负荷(TIB)及彩超的心功能指标,随访统计两组心绞痛发作、因急性冠状动脉综合征再入院、非致死性心肌梗死和死亡等主要不良心血管事件(MACE)的例数。结果随访6个月或至死亡终点,与对照组比较,曲美他嗪治疗组24 h的TIB显著降低(P<0.05),左室容积缩小,左室射血分数提高(P<0.05),再发心绞痛发作例数及MACE发生例数显著降低(P<0.05)。结论在常规优化治疗的基础上加用曲美他嗪,有进一步减少缺血事件、改善左心功能、减少MACE的作用。Objective To observe the effects of trimetazidine （TMZ） on optimized conventional standard treatment of patients with multivessel coronary disease without revascularization. Methods One hundred and fifteen patients with mul- tivessel coronary disease without revascularization were randomly divided into two groups： the control group and the TMZ group. Both groups were treated with optimized conventional standard drugs, while TMZ group were given TMZ in addition. The treatment course was 6 months. All patients were given the 24 h Holter electrocardiogram and echocardiography before treatment and 6 months later. Recmxent angina and major adverse cardiac events （MACE,including readmission, myocar- dio-infarction and death） were observed, The data from total 115 patients were used for statistical analysis. Results The 24 h total ischemia burden（TIB） reduced, the heart function improved more, the recurrence of angina pectoris lowered, and MACE much less in TMZ group than those in control group（P 〈 0. 05）. Conclusion The clinical effects are signifi- cantly improved by trimetazidine for treating patients with multivessel coronary disease without revascularization. Trimetazi- dine has an important role in addition to optimized conventional standard treatment.

关 键 词：曲美他嗪 冠状动脉多支病变 非血运重建 

分 类 号：R541.4[医药卫生—心血管疾病]